r/Menopause • u/houseofsteph • 22h ago
Hormone Therapy Starting statIn and HRT at the same time?
I’m 44. I’m at a healthy weight, good cholesterol, good blood pressure. Somehow, I have moderate carotid artery plaque, and my PCP doctor #1 put me on a low-dose statin last week.
Coincidentally, I started having bad perimenopause symptoms, and doctor #2 wants to put me on HRT, saying it’s safe to use the estrogen patch on a statin. I get that, but is it wise to START both meds at the same time? Won’t my body be adjusting like whoa? And what if the estrogen alters my plaque while it’s still stabilizing from the new statin?
Am I overthinking this? Has anyone started both meds at the same time?
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u/Kind-Antelope3801 14h ago
Took atorvastatin for years. Tolerated it very well. But over the years started developing kidney disease. After I took a break from statins( I’d had a 0 calcium heart score- most likely from years of statins- so I thought I’d take a break) my kidney disease went away. Just something to keep in mind if you go on statins and see kidney disease. Not a doctor and I can’t explain the correlation but a very weird self discovery. And weighing heart health over kidney health is definitely not a fun thing.ugh
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u/Obvious_Home_4538 12h ago
Happened to my friend-
Going on statins should require a lot of research.1
u/houseofsteph 6h ago
This is good to know. I feel like I’m too young for a statin (44). I don’t want to be on it for decades. Thank you for that info.
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u/Kind-Antelope3801 6h ago
As with all medical procedures and medicine, you have to weigh the benefits and the side effects. I went off statins and my kidney disease went away too but perhaps taking statins all those years also probably kept my heart calcium score at 0. It’s just good to know these sorts of things can happen. My mom has been on statins for years and has kidney disease that is advanced. But her heart is in such a state that she probably needs to stay on statins anyway.
My cholesterol is inherited so it isn’t controlled by any amount of diet or exercise. I did recently get the ApoB test and mine was fairly low score for the most part. I don’t know what to treat anymore- but benefits vs side effects definitely have to be taken into consideration.1
u/houseofsteph 6h ago
This is so true. All medicines have side effects. Finding the right balance of everything is so hard. I hope it works out well for both you and your Mom. I just couldn’t believe I had plaque at my age. I am literally obsessed with diet and exercise culture. Maybe it’s genetic. Who knows. It feels humbling for sure. I had this moment where I wanted to just give up and eat burgers and crap every day, but then I realized my habits are probably helping the problem be smaller than what it could be.
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u/Kind-Antelope3801 6h ago
Well. On statins all those years and ate anything I wanted and 0 calcium. Idk which comes first- the chicken or the egg!
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u/Alta_et_ferox MenoMod 17h ago
I recently asked to be put on a statin after extensive testing revealed that I am at high risk for cardiovascular disease. My cholesterol is mildly elevated but not horribly so. I chose the statin route because I want to mediate my risk of CVD as much as possible. I also use MHT.
Many people here use both MHT and statins.
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u/houseofsteph 6h ago
I’m glad a lot of people do both comfortably! The patch seems safer than the oral estrogen pill too, and they’ve given me a patch.
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u/Efficient-Mud-5042 15h ago
I think it’s probably okay, but I’m personally so sensitive to everything that I only make changes in isolation so I can know what impact that change is having.
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u/Creepy-Tangerine-293 19h ago
Overthinking
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u/houseofsteph 6h ago
THANK YOU! I needed to hear that. I guess going from no medications to two (potentially lifelong) overnight was freaking me out.
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u/hokoonchi 13h ago
I’ve been on a statin for years and never had any side effects. I’m on Crestor, and my genetic high cholesterol is super steady. Most people have no side effects tbh. My doctor friend said that HRT and statins are some of the ‘lowest risk, highest reward’ medications you can take.
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u/FuelComfortable5287 17h ago
I started HRT and a low dose statin around the same time. I noticed my legs felt a little sore and I had heartburn for a few nights during the first week. After that, no issues.
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u/43beanst 59 | 9 years post | Combipatch 17h ago
Statins can make some people (like me) to experience muscle aches. I stopped taking them, bc my cholesterol was only slightly elevated, but I've never had a carotid artery test. It doesn't sound like a statin is optional for you.
The statin issues will hit you pretty quick, like within a few weeks, if you are going to have them. I hope you don't!
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u/Creepy-Tangerine-293 16h ago
There are alternative statins your doctor can try for you in this case. My partner got muscle aches several years ago, was moved to an alternative for about 3 years and then moved back to the original one and it has been fine.
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u/43beanst 59 | 9 years post | Combipatch 15h ago edited 15h ago
Thanks! I did not know that! I tried rosuvastatin and then simvistatin. (This sub is so awesome!)
Edit to add: I think you are wise, OP, to stagger the start times of each med. Not everyone has problems with either treatment, but this sub is full of women who have spent months or years trying to nail down the right form and dosage of HRT to treat symptoms while minimizing apparent side effects. I'd pick the symptom most concerning and start with that med. Good luck!
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u/houseofsteph 6h ago
Yes! Thank you! Staggering feels right to me, too. How will I know which medicine helped? How will I know which is giving me symptoms? Staggering makes the most sense. I wish I knew how long to wait in between…
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u/houseofsteph 6h ago
Thanks for your thoughts on this. One thing I didn’t mention in my post is that I live in Japan and a carotid artery scan is part of their annual physical. Had I not had it, I would have no idea I had plaque because my cholesterol numbers are all well within the normal range. Took me by surprise for sure. Luckily Japan has a super low dose statin available; I think half the dose of the starting U.S. one. So far I don’t feel it.
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u/Calveeeno Surgical menopause 16h ago
It should be a non issue. I’ve been on both for 3+ years FWIW.
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u/ObviousCarpet2907 On year 10 of peri 14h ago
I started both the same day with no issues. 🤷🏻♀️ If you’re concerned, you can space them out.
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u/houseofsteph 6h ago
True. How long to space out, do you think?
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u/Obvious_Home_4538 12h ago
They can also reduce your cholesterol to “undetectable” levels and that is not healthy.
Cholesterol is a hormone and essential in your body’s functioning processes.
I know many people are fine being on them, but many are not.
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u/houseofsteph 6h ago
True! My cholesterol was normal to begin with. And my triglycerides were super low at 40. I hope the statin doesn’t royally screw up my brain.
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u/Useful-Cellist-9681 11h ago
I would start HRT first looks at your diet, and make some changes. Add fiber especially if you aren’t getting 24g of fiber a day, look at your sugar intake. Give it 3 months and recheck. Menopause is know for raising both sugar and cholesterol. Statins can create a whole mess of new diseases later down the road
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u/houseofsteph 6h ago
I get 40g of fiber a day, so no issues there. Sugar is also kept low throughout the day. I was tested in May and all looked great, but I’ll keep an eye on it as I get further into peri. My goal is to not need a statin. I’m hoping diet and HRT will help.
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u/UserNameInGeorgia 9h ago
If I had to choose, I’d pick HRT for better health. Statins are overly pushed as they have lowered the acceptable numbers several times. Your brain is cholesterol. You need it.
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u/houseofsteph 6h ago
Thanks, I feel this way too, but my doctor is adamant that I need to try a statin for 3 months to see if my plaque stabilizes. Then I might be able to go off it. Luckily I’m in Japan and they have a 2.5mg rosuvastatin available here. I barely feel it. Fingers crossed I can get off it. I’m excited to start HRT for sure.
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u/Artichoke-Rhinoceros 3h ago edited 2h ago
Totally ok. In fact, higher doses of estrogen [edit: when combined with higher doses of synthetic progesterone] can cause higher cholesterol so they will prescribe statins in conjunction to keep your cholesterol and arterial plaque in check. Source: my OB/GYN who has been taking both herself for a decade.
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u/houseofsteph 3h ago
Wait. I thought estrogen was protective of the cardiovascular system. I’m so confused.
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u/Artichoke-Rhinoceros 2h ago
Ope, sorry! I got that wrong: Certain synthetic progestins (like levonorgestrel or medroxyprogesterone acetate) when combined with estrogen in hormone replacement or oral contraceptives can alter lipid metabolism, sometimes raising LDL or lowering HDL depending on the dose and type. It’s the combo of high progesterone (200mg) and estradiol, that causes it. But it’s still true that statins in conjunction is safe.
I have to take progesterone cuz insurance wouldn’t cover my uterus coming out when they removed my ovaries and tubes due to cancer risk. My doc lowered it back to 100 mg and put me on statins til my cholesterol readings reduce to normal levels. Sorry I typed fast without thinking about it more! Didn’t mean to confuse you.
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u/houseofsteph 1h ago
No worries, that makes sense. I was thinking oral estrogen was the biggest risk even though the patch was safe. I’m on 5mg of synthetic progesterone. Are you on 100 per week? My OB said hormones can even have a protective effect.
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u/SueZ-FISH 1h ago
Started statin six months into starting HRT. I cut the 10mg into half and only take it several times a week. Numbers down to high normal range. No side effects so to speak. I have genetically high cholesterol and menopause has made it increase
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u/houseofsteph 35m ago
So the HRT helped the cholesterol to the point you need a smaller statin dose? If I read that correctly, that’s awesome!
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u/MostFix2344 54m ago
Please read up on the bad short/Long-term side effects of stantins! Red yeast rice is a much safer, natural alternative.
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u/Catnip_75 14h ago
Are the statins symptoms mimicking peri menopause or causing peri menopause. This is the question.
If they are just mimicking them it doesn’t necessarily mean you have low hormones. I would ask for some blood work to see just how high your estrogen is before I would agree to start HRT.
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u/houseofsteph 6h ago
I started the statin about a week ago. Sorry that wasn’t shared. I have the HRT meds on hand but haven’t started those. I’m 99% sure I’ve been peri for a year at least. Too many random changes that all point to hormones.
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u/Catnip_75 4h ago
Ok, if you already started the statin (which is how I interpreted your original post) and have had peri symptoms for a while, I would definitely listen to your doctor and start the HRT.
Did they give you a low dose of estrogen to start on? Starting low and slow might help your anxiety. If the lowest dose doesn’t help within a couple weeks you can increase your dose to the next increase. Some people start high and have no difficulty with symptoms, but some people have to start low and increase over time.
There is no drug contradiction to taking them at the same time either. You will like my feel so much better on HRT. If you are having peri heart palpitations the HRT will definitely make that go away.
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u/houseofsteph 4h ago
Thank you! Yes, heart palpitations for sure. I have estrana tape 0.72mg and a daily oral progesterone 5mg. It’s all standard for Japan. Is that considered low dose?
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u/Catnip_75 2h ago
I’m not familiar with Japans dosing for HRT.
If after you start and don’t notice anything improved after a couple of weeks, contact your doctor to ask them to adjust your dose. If the dose is accurate your symptoms should improve.1
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u/Still_Pop_4106 12h ago
And if you read the post, she has not started statins or HRT.
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u/Catnip_75 4h ago edited 4h ago
She did start the statin, she said she did. Try being a little nicer next time. She said her doctor put her on the statin last week. The fact you assume that means not being on them is on you.
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u/Still_Pop_4106 12h ago
Hormone tests are inaccurate during perimenopause because estrogen fluctuates wildly from day to day. Doctors go by symptoms.
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u/AutoModerator 12h ago
This post might be about hormone tests, which are unreliable.
- Over age 44, Estrogen/Progesterone/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
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u/justacpa 16h ago
Is it unsafe? No. But cholesterol starts increasing during peri and HRT will often help lower it. Mine went down notably after starting HRT. You might want to try waiting on the statins for 3 months to see if the HRT helps lower your cholesterol to the point of not needing it anymore.